There has been a lot of controversy recently over the Irish Cancer Society’s new awareness

Dearbhla Lenehan

campaign. Did you know, more people will actually die from bacterial-related illnesses than from common cancers? With increasing emergence of antibiotic resistant bacteria this figure will only continue to rise. Dearbhla Lenehan, an Infection Biology PhD student and member of Transition Monaghan explains what antibiotic resistance is and measures we can take to slow down the development of these superbugs.

For a long time the idea of antibiotic resistant bacteria has seemed farfetched or theoretical. When this topic is brought up the response is usually ‘they’ll find another drug or I’m sure something else will work’. Unfortunately, at present, there are no alternatives. In 2015, a bacterium resistant to the ‘last resort’ antibiotic colistin was identified for the first time in China. In 2016 similar findings were found in European countries. Now in 2017 an American woman has died from an infection caused by a superbug resistant to every available antibiotic. Could this be the start of a superbug-killing spree? Unfortunately, antibiotic resistance is increasing and is an issue that affects us all. The main cause of these resistances arises from misuse and overuse of antibiotics.

This graphic shows the routine antibiotic resistance test scientists use. The yellow lines are bacteria; the white circles are disks that contain different antibiotics. When you see a clear circular zone around these disks, that particular antibiotic is killing the bacteria. However, this bacterium is resistant to 3 of the antibiotics tested, as there is no circular killing zone surrounding three disks.

While, on the one hand, antibiotics save millions of lives, on the other hand, antibiotic resistance has been described as one of the world’s most pressing public health problems. Since 2000, there has been a steady increase in the prevalence of antibiotic resistant bacteria. Once easily treatable infections have now become extremely difficult if not impossible to treat; leading to immense discomfort and in some cases can be fatal.

MISUSE

How has this antibiotic resistance come about? Simply – misuse and overuse. Every time you take antibiotics, sensitive bacteria are killed. Antibiotics put a selective pressure on bacteria and in a bid to survive bacteria can manipulate their genetic material or acquire pieces of DNA that code for the resistance properties from other bacteria. Misusing antibiotics is taking antibiotics for a viral infection like a cold or flu. Antibiotics can only treat bacterial infections and won’t help your flu. Another example of misuse is if you do not finish your full course of medication, or do not take it exactly as directed by your doctor. In this case, not all of your infecting bacteria are killed off and in a bid to survive and re-infect they begin to multiply and can find ways to acquire antibiotic resistance.

OVERUSE

Overuse of antibiotics primarily occurs in the farming industry. In Ireland there are strict guidelines regarding the use of antibiotics in farming. However, even with this, a recent report published by the Food Safety Authority of Ireland found that there is still potential for antimicrobial resistance transmission in the food chain. This transmission can occur if we eat meat that’s contaminated with antimicrobial-resistant bacteria, which is more likely in food from animals that received antimicrobial agents. It can also occur when animals treated with antibiotics urinate or defecate. Then traces of these antibiotics enter the soil and bacteria can gain resistance to them. These resistance genes can then be easily passed on to other bacteria and spread.

Bacterial-related illnesses affect the most vulnerable; the young, the old, those receiving chemotherapy and those undergoing organ transplants. Commonly, patients suffering from a completely different disease, sadly end up succumbing to secondary infections. Unfortunately, as more and more bugs gain antibiotic resistance, it’s becoming increasing difficult to help these patients. However, if we act now to inform ourselves about antibiotic use, only take them when we really need them and avoid their overuse, including in farming, we can slow down the emergence of these killer superbugs.

Alexander Fleming, the discoverer of penicillin, said 72 years ago “the thoughtless person

Alexander Fleming

playing with penicillin treatment is morally responsible for the death of the man who succumbs to infection by penicillin resistance”. Unfortunately, his words are becoming a reality and with the increasing prevalence of antibiotic resistance, we will soon enter a post-antibiotic world.

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